Doctors Are Not Prescribing the Right Kind of Drugs for the Flu

The old adage that no medicine can cure a virus hasn't been true since the 1990s. But try telling America's doctors that.

Government-led research published Wednesday in Clinical Infectious Diseases concluded that influenza sufferers visiting outpatient clinics were over-prescribed antibiotics, which can harm flu patients but won't do anything to stave off the virus that's triggering their symptoms. They were under-prescribed antiviral drugs (such as oseltamivir and zanamivir, which are often marketed as Tamiflu and Relenza) that most experts say should be used by some flu sufferers.

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"A very high proportion of people who had influenza were not prescribed antivirals drugs," says Fiona Havers, an Atlanta-based infectious diseases physician and Centers for Disease Control and Prevention influenza researcher. Havers was among a large team of scientists who analyzed the medical records and lab results of thousands of patients seeking care for acute respiratory illnesses at five medical centers from 2011 to 2013. "We found that these drugs are not very frequently prescribed to people for whom we would recommend that they be prescribed."

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Of the 1,021 confirmed flu sufferers who the research team believes should have received an antiviral drug prescription, just 19 percent received one.

Havers says the drugs should be prescribed to people who run high risks of developing health complications when infected by the flu, such as the elderly, the young, and those with other chronic medical conditions such as diabetes or heart conditions. The drugs are most effective if taken within two days of the onset of symptoms. They can stop or slow the spread of a virus through a patient's cells.

The researchers performed tests on patients that are rarely available to doctors. Of the 1,021 confirmed flu sufferers who the research team believes should have received an antiviral drug prescription, just 19 percent received one.

"We found that a higher proportion of people were prescribed antibiotics than antiviral drugs," Havers says.

Of 1,825 patients who were confirmed through lab tests to be suffering from the flu, nearly a third were given a prescription for one of three types of antibiotics. Many more might have been prescribed types of antibiotics that were not tracked by the study.

"Antibiotics work against bacteria, so they don’t help," Havers says. "There's definitely a risk of harm from getting an unnecessary antibiotic prescription." Those risks include the worsening of antibiotic resistance, adverse reactions to the drugs, and the killing off of beneficial bugs. "We’re learning more and more about potentially harmful effects of the unnecessary use of antibiotics."

So why would so many doctors be doing their jobs wrong?

"I think some if it is a lack of awareness that these antiviral drugs are beneficial," Havers says. "There has been some controversy about whether they are beneficial. But there's a lot of evidence that they do work, particularly in these high risk groups."

Patients currently have to rely on trust that their doctors prescribe them the right drugs. Prescriber Checkup allows patients to see, for the first time, how health care providers stack up with peers.